Class: CandidApiClient::Encounters::V4::Types::EncounterCreateFromPreEncounter

Inherits:
Object
  • Object
show all
Defined in:
lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb

Constant Summary collapse

OMIT = 
Object.new

Instance Attribute Summary collapse

Class Method Summary collapse

Instance Method Summary collapse

Constructor Details

#initialize(pre_encounter_patient_id:, pre_encounter_appointment_ids:, billing_provider:, rendering_provider:, diagnoses:, place_of_service_code:, external_id:, patient_authorized_release:, benefits_assigned_to_provider:, provider_accepts_assignment:, billable_status:, initial_referring_provider: OMIT, supervising_provider: OMIT, service_facility: OMIT, clinical_notes: OMIT, billing_notes: OMIT, patient_histories: OMIT, service_lines: OMIT, external_claim_submission: OMIT, tag_ids: OMIT, schema_instances: OMIT, date_of_service: OMIT, end_date_of_service: OMIT, appointment_type: OMIT, existing_medications: OMIT, vitals: OMIT, interventions: OMIT, pay_to_address: OMIT, synchronicity: OMIT, additional_information: OMIT, service_authorization_exception_code: OMIT, admission_date: OMIT, discharge_date: OMIT, onset_of_current_illness_or_symptom_date: OMIT, last_menstrual_period_date: OMIT, delay_reason_code: OMIT, additional_properties: nil) ⇒ CandidApiClient::Encounters::V4::Types::EncounterCreateFromPreEncounter

Parameters:

  • pre_encounter_patient_id (String)
  • pre_encounter_appointment_ids (Array<String>)
  • billing_provider (CandidApiClient::EncounterProviders::V2::Types::BillingProvider) —

    The billing provider is the provider or business entity submitting the claim. Billing provider may be, but is not necessarily, the same person/NPI as the rendering provider. From a payer’s perspective, this represents the person or entity being reimbursed. When a contract exists with the target payer, the billing provider should be the entity contracted with the payer. In some circumstances, this will be an individual provider. In that case, submit that provider’s NPI and the tax ID (TIN) that the provider gave to the payer during contracting. In other cases, the billing entity will be a medical group. If so, submit the group NPI and the group’s tax ID. Box 33 on the CMS-1500 claim form.

  • rendering_provider (CandidApiClient::EncounterProviders::V2::Types::RenderingProvider) —

    The rendering provider is the practitioner – physician, nurse practitioner, etc. – performing the service. For telehealth services, the rendering provider performs the visit, asynchronous communication, or other service. The rendering provider address should generally be the same as the service facility address.

  • initial_referring_provider (CandidApiClient::EncounterProviders::V2::Types::InitialReferringProvider) (defaults to: OMIT) —

    The second iteration of Loop ID-2310. Use code “P3 - Primary Care Provider” in this loop to indicate the initial referral from the primary care provider or whatever provider wrote the initial referral for this patient’s episode of care being billed/reported in this transaction.

  • supervising_provider (CandidApiClient::EncounterProviders::V2::Types::SupervisingProvider) (defaults to: OMIT) —

    Required when the rendering provider is supervised by a physician. If not required by this implementation guide, do not send.

  • service_facility (CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityBase) (defaults to: OMIT) —

    Encounter Service facility is typically the location a medical service was rendered, such as a provider office or hospital. For telehealth, service facility can represent the provider’s location when the service was delivered (e.g., home), or the location where an in-person visit would have taken place, whichever is easier to identify. If the provider is in-network, service facility may be defined in payer contracts. Box 32 on the CMS-1500 claim form. Note that for an in-network claim to be successfully adjudicated, the service facility address listed on claims must match what was provided to the payer during the credentialing process.

  • diagnoses (Array<CandidApiClient::Diagnoses::Types::DiagnosisCreate>) —

    Ideally, this field should contain no more than 12 diagnoses. However, more diagnoses may be submitted at this time, and coders will later prioritize the 12 that will be submitted to the payor.

  • clinical_notes (Array<CandidApiClient::Encounters::V4::Types::ClinicalNoteCategoryCreate>) (defaults to: OMIT) —

    Holds a collection of clinical observations made by healthcare providers during patient encounters.

  • billing_notes (Array<CandidApiClient::BillingNotes::V2::Types::BillingNoteBase>) (defaults to: OMIT) —

    Spot to store misc, human-readable, notes about this encounter to be used in the billing process.

  • place_of_service_code (CandidApiClient::Commons::Types::FacilityTypeCode) —

    Box 24B on the CMS-1500 claim form. 837p Loop2300, CLM-05-1. 02 for telemedicine, 11 for in-person. Full list [here](www.cms .gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).

  • patient_histories (Array<CandidApiClient::Encounters::V4::Types::PatientHistoryCategory>) (defaults to: OMIT)
  • service_lines (Array<CandidApiClient::ServiceLines::V2::Types::ServiceLineCreate>) (defaults to: OMIT) —

    Each service line must be linked to a diagnosis. Concretely, ‘service_line.diagnosis_pointers`must contain at least one entry which should be in bounds of the diagnoses list field.

  • external_claim_submission (CandidApiClient::ClaimSubmission::V1::Types::ExternalClaimSubmissionCreate) (defaults to: OMIT) —

    To be included for claims that have been submitted outside of Candid. Candid supports posting remits and payments to these claims and working them in-platform (e.g. editing, resubmitting).

  • tag_ids (Array<String>) (defaults to: OMIT) —

    Names of tags that should be on the encounter.

  • schema_instances (Array<CandidApiClient::CustomSchemas::V1::Types::SchemaInstance>) (defaults to: OMIT) —

    Key-value pairs that must adhere to a schema created via the Custom Schema API. Multiple schema instances cannot be created for the same schema on an encounter.

  • external_id (String) —

    A client-specified unique ID to associate with this encounter; for example, your internal encounter ID or a Dr. Chrono encounter ID. This field should not contain PHI.

  • date_of_service (Date) (defaults to: OMIT) —

    Date formatted as YYYY-MM-DD; eg: 2019-08-24. This date must be the local date in the timezone where the service occurred. Box 24a on the CMS-1500 claim form. If service occurred over a range of dates, this should be the start date. date_of_service must be defined on either the encounter or the service lines but not both. If there are greater than zero service lines, it is recommended to specify date_of_service on the service_line instead of on the encounter to prepare for future API versions.

  • end_date_of_service (Date) (defaults to: OMIT) —

    Date formatted as YYYY-MM-DD; eg: 2019-08-25. This date must be the local date in the timezone where the service occurred. If omitted, the Encounter is assumed to be for a single day. Must not be temporally before the date_of_service field. If there are greater than zero service lines, it is recommended to specify end_date_of_service on the service_line instead of on the encounter to prepare for future API versions.

  • patient_authorized_release (Boolean) —

    Whether this patient has authorized the release of medical information for billing purpose. Box 12 on the CMS-1500 claim form.

  • benefits_assigned_to_provider (Boolean) —

    Whether this patient has authorized insurance payments to be made to you, not them. If false, patient may receive reimbursement. Box 13 on the CMS-1500 claim form.

  • provider_accepts_assignment (Boolean) —

    Whether you have accepted the patient’s authorization for insurance payments to be made to you, not them. Box 27 on the CMS-1500 claim form.

  • appointment_type (String) (defaults to: OMIT) —

    Human-readable description of the appointment type (ex: “Acupuncture - Headaches”).

  • existing_medications (Array<CandidApiClient::Encounters::V4::Types::Medication>) (defaults to: OMIT)
  • vitals (CandidApiClient::Encounters::V4::Types::Vitals) (defaults to: OMIT)
  • interventions (Array<CandidApiClient::Encounters::V4::Types::Intervention>) (defaults to: OMIT)
  • pay_to_address (CandidApiClient::Commons::Types::StreetAddressLongZip) (defaults to: OMIT) —

    Specifies the address to which payments for the claim should be sent.

  • synchronicity (CandidApiClient::Encounters::V4::Types::SynchronicityType) (defaults to: OMIT) —

    Whether or not this was a synchronous or asynchronous encounter. Asynchronous encounters occur when providers and patients communicate online using forms, instant messaging, or other pre-recorded digital mediums. Synchronous encounters occur in live, real-time settings where the patient interacts directly with the provider, such as over video or a phone call.

  • billable_status (CandidApiClient::Encounters::V4::Types::BillableStatusType) —

    Defines if the Encounter is to be billed by Candid to the responsible_party. Examples for when this should be set to NOT_BILLABLE include if the Encounter has not occurred yet or if there is no intention of ever billing the responsible_party.

  • additional_information (String) (defaults to: OMIT) —

    Defines additional information on the claim needed by the payer. Box 19 on the CMS-1500 claim form.

  • service_authorization_exception_code (CandidApiClient::Encounters::V4::Types::ServiceAuthorizationExceptionCode) (defaults to: OMIT) —

    837p Loop2300 REF*4N Required when mandated by government law or regulation to obtain authorization for specific service(s) but, for the reasons listed in one of the enum values of ServiceAuthorizationExceptionCode, the service was performed without obtaining the authorization.

  • admission_date (Date) (defaults to: OMIT) —

    837p Loop2300 DTP*435, CMS-1500 Box 18 Required on all ambulance claims when the patient was known to be admitted to the hospital. OR Required on all claims involving inpatient medical visits.

  • discharge_date (Date) (defaults to: OMIT) —

    837p Loop2300 DTP*096, CMS-1500 Box 18 Required for inpatient claims when the patient was discharged from the facility and the discharge date is known.

  • onset_of_current_illness_or_symptom_date (Date) (defaults to: OMIT) —

    837p Loop2300 DTP*431, CMS-1500 Box 14 Required for the initial medical service or visit performed in response to a medical emergency when the date is available and is different than the date of service. OR This date is the onset of acute symptoms for the current illness or condition.

  • last_menstrual_period_date (Date) (defaults to: OMIT) —

    837p Loop2300 DTP*484, CMS-1500 Box 14 Required when, in the judgment of the provider, the services on this claim are related to the patient’s pregnancy.

  • delay_reason_code (CandidApiClient::Commons::Types::DelayReasonCode) (defaults to: OMIT) —

    837i Loop2300, CLM-1300 Box 20 Code indicating the reason why a request was delayed

  • additional_properties (OpenStruct) (defaults to: nil) —

    Additional properties unmapped to the current class definition



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 333

def initialize(pre_encounter_patient_id:, pre_encounter_appointment_ids:, billing_provider:,
               rendering_provider:, diagnoses:, place_of_service_code:, external_id:, patient_authorized_release:, benefits_assigned_to_provider:, provider_accepts_assignment:, billable_status:, initial_referring_provider: OMIT, supervising_provider: OMIT, service_facility: OMIT, clinical_notes: OMIT, billing_notes: OMIT, patient_histories: OMIT, service_lines: OMIT, external_claim_submission: OMIT, tag_ids: OMIT, schema_instances: OMIT, date_of_service: OMIT, end_date_of_service: OMIT, appointment_type: OMIT, existing_medications: OMIT, vitals: OMIT, interventions: OMIT, pay_to_address: OMIT, synchronicity: OMIT, additional_information: OMIT, service_authorization_exception_code: OMIT, admission_date: OMIT, discharge_date: OMIT, onset_of_current_illness_or_symptom_date: OMIT, last_menstrual_period_date: OMIT, delay_reason_code: OMIT, additional_properties: nil)
  @pre_encounter_patient_id = pre_encounter_patient_id
  @pre_encounter_appointment_ids = pre_encounter_appointment_ids
  @billing_provider = billing_provider
  @rendering_provider = rendering_provider
  @initial_referring_provider = initial_referring_provider if initial_referring_provider != OMIT
  @supervising_provider = supervising_provider if supervising_provider != OMIT
  @service_facility = service_facility if service_facility != OMIT
  @diagnoses = diagnoses
  @clinical_notes = clinical_notes if clinical_notes != OMIT
  @billing_notes = billing_notes if billing_notes != OMIT
  @place_of_service_code = place_of_service_code
  @patient_histories = patient_histories if patient_histories != OMIT
  @service_lines = service_lines if service_lines != OMIT
  @external_claim_submission = external_claim_submission if external_claim_submission != OMIT
  @tag_ids = tag_ids if tag_ids != OMIT
  @schema_instances = schema_instances if schema_instances != OMIT
  @external_id = external_id
  @date_of_service = date_of_service if date_of_service != OMIT
  @end_date_of_service = end_date_of_service if end_date_of_service != OMIT
  @patient_authorized_release = patient_authorized_release
  @benefits_assigned_to_provider = benefits_assigned_to_provider
  @provider_accepts_assignment = provider_accepts_assignment
  @appointment_type = appointment_type if appointment_type != OMIT
  @existing_medications = existing_medications if existing_medications != OMIT
  @vitals = vitals if vitals != OMIT
  @interventions = interventions if interventions != OMIT
  @pay_to_address = pay_to_address if pay_to_address != OMIT
  @synchronicity = synchronicity if synchronicity != OMIT
  @billable_status = billable_status
  @additional_information = additional_information if additional_information != OMIT
  if service_authorization_exception_code != OMIT
    @service_authorization_exception_code = service_authorization_exception_code
  end
  @admission_date = admission_date if admission_date != OMIT
  @discharge_date = discharge_date if discharge_date != OMIT
  if onset_of_current_illness_or_symptom_date != OMIT
    @onset_of_current_illness_or_symptom_date = onset_of_current_illness_or_symptom_date
  end
  @last_menstrual_period_date = last_menstrual_period_date if last_menstrual_period_date != OMIT
  @delay_reason_code = delay_reason_code if delay_reason_code != OMIT
  @additional_properties = additional_properties
  @_field_set = {
    "pre_encounter_patient_id": pre_encounter_patient_id,
    "pre_encounter_appointment_ids": pre_encounter_appointment_ids,
    "billing_provider": billing_provider,
    "rendering_provider": rendering_provider,
    "initial_referring_provider": initial_referring_provider,
    "supervising_provider": supervising_provider,
    "service_facility": service_facility,
    "diagnoses": diagnoses,
    "clinical_notes": clinical_notes,
    "billing_notes": billing_notes,
    "place_of_service_code": place_of_service_code,
    "patient_histories": patient_histories,
    "service_lines": service_lines,
    "external_claim_submission": external_claim_submission,
    "tag_ids": tag_ids,
    "schema_instances": schema_instances,
    "external_id": external_id,
    "date_of_service": date_of_service,
    "end_date_of_service": end_date_of_service,
    "patient_authorized_release": patient_authorized_release,
    "benefits_assigned_to_provider": benefits_assigned_to_provider,
    "provider_accepts_assignment": provider_accepts_assignment,
    "appointment_type": appointment_type,
    "existing_medications": existing_medications,
    "vitals": vitals,
    "interventions": interventions,
    "pay_to_address": pay_to_address,
    "synchronicity": synchronicity,
    "billable_status": billable_status,
    "additional_information": additional_information,
    "service_authorization_exception_code": service_authorization_exception_code,
    "admission_date": admission_date,
    "discharge_date": discharge_date,
    "onset_of_current_illness_or_symptom_date": onset_of_current_illness_or_symptom_date,
    "last_menstrual_period_date": last_menstrual_period_date,
    "delay_reason_code": delay_reason_code
  }.reject do |_k, v|
    v == OMIT
  end
end

Instance Attribute Details

#additional_information ⇒ String (readonly)

Returns Defines additional information on the claim needed by the payer. Box 19 on the CMS-1500 claim form.

Returns:

  • (String) —

    Defines additional information on the claim needed by the payer. Box 19 on the CMS-1500 claim form.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 164

def additional_information
  @additional_information
end

#additional_properties ⇒ OpenStruct (readonly)

Returns Additional properties unmapped to the current class definition.

Returns:

  • (OpenStruct) —

    Additional properties unmapped to the current class definition



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 197

def additional_properties
  @additional_properties
end

#admission_date ⇒ Date (readonly)

Returns 837p Loop2300 DTP*435, CMS-1500 Box 18 Required on all ambulance claims when the patient was known to be admitted to the hospital. OR Required on all claims involving inpatient medical visits.

Returns:

  • (Date) —

    837p Loop2300 DTP*435, CMS-1500 Box 18 Required on all ambulance claims when the patient was known to be admitted to the hospital. OR Required on all claims involving inpatient medical visits.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 177

def admission_date
  @admission_date
end

#appointment_type ⇒ String (readonly)

Returns Human-readable description of the appointment type (ex: “Acupuncture - Headaches”).

Returns:

  • (String) —

    Human-readable description of the appointment type (ex: “Acupuncture - Headaches”).



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 140

def appointment_type
  @appointment_type
end

#benefits_assigned_to_provider ⇒ Boolean (readonly)

Returns Whether this patient has authorized insurance payments to be made to you, not them. If false, patient may receive reimbursement. Box 13 on the CMS-1500 claim form.

Returns:

  • (Boolean) —

    Whether this patient has authorized insurance payments to be made to you, not them. If false, patient may receive reimbursement. Box 13 on the CMS-1500 claim form.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 133

def benefits_assigned_to_provider
  @benefits_assigned_to_provider
end

#billable_status ⇒ CandidApiClient::Encounters::V4::Types::BillableStatusType (readonly)

Returns Defines if the Encounter is to be billed by Candid to the responsible_party. Examples for when this should be set to NOT_BILLABLE include if the Encounter has not occurred yet or if there is no intention of ever billing the responsible_party.

Returns:

  • (CandidApiClient::Encounters::V4::Types::BillableStatusType) —

    Defines if the Encounter is to be billed by Candid to the responsible_party. Examples for when this should be set to NOT_BILLABLE include if the Encounter has not occurred yet or if there is no intention of ever billing the responsible_party.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 161

def billable_status
  @billable_status
end

#billing_notes ⇒ Array<CandidApiClient::BillingNotes::V2::Types::BillingNoteBase> (readonly)

Returns Spot to store misc, human-readable, notes about this encounter to be used in the billing process.

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 83

def billing_notes
  @billing_notes
end

#billing_provider ⇒ CandidApiClient::EncounterProviders::V2::Types::BillingProvider (readonly)

Returns The billing provider is the provider or business entity submitting the claim. Billing provider may be, but is not necessarily, the same person/NPI as the rendering provider. From a payer’s perspective, this represents the person or entity being reimbursed. When a contract exists with the target payer, the billing provider should be the entity contracted with the payer. In some circumstances, this will be an individual provider. In that case, submit that provider’s NPI and the tax ID (TIN) that the provider gave to the payer during contracting. In other cases, the billing entity will be a medical group. If so, submit the group NPI and the group’s tax ID. Box 33 on the CMS-1500 claim form.

Returns:

  • (CandidApiClient::EncounterProviders::V2::Types::BillingProvider) —

    The billing provider is the provider or business entity submitting the claim. Billing provider may be, but is not necessarily, the same person/NPI as the rendering provider. From a payer’s perspective, this represents the person or entity being reimbursed. When a contract exists with the target payer, the billing provider should be the entity contracted with the payer. In some circumstances, this will be an individual provider. In that case, submit that provider’s NPI and the tax ID (TIN) that the provider gave to the payer during contracting. In other cases, the billing entity will be a medical group. If so, submit the group NPI and the group’s tax ID. Box 33 on the CMS-1500 claim form.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 46

def billing_provider
  @billing_provider
end

#clinical_notes ⇒ Array<CandidApiClient::Encounters::V4::Types::ClinicalNoteCategoryCreate> (readonly)

Returns Holds a collection of clinical observations made by healthcare providers during patient encounters.

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 80

def clinical_notes
  @clinical_notes
end

#date_of_service ⇒ Date (readonly)

Returns Date formatted as YYYY-MM-DD; eg: 2019-08-24. This date must be the local date in the timezone where the service occurred. Box 24a on the CMS-1500 claim form. If service occurred over a range of dates, this should be the start date. date_of_service must be defined on either the encounter or the service lines but not both. If there are greater than zero service lines, it is recommended to specify date_of_service on the service_line instead of on the encounter to prepare for future API versions.

Returns:

  • (Date) —

    Date formatted as YYYY-MM-DD; eg: 2019-08-24. This date must be the local date in the timezone where the service occurred. Box 24a on the CMS-1500 claim form. If service occurred over a range of dates, this should be the start date. date_of_service must be defined on either the encounter or the service lines but not both. If there are greater than zero service lines, it is recommended to specify date_of_service on the service_line instead of on the encounter to prepare for future API versions.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 117

def date_of_service
  @date_of_service
end

#delay_reason_code ⇒ CandidApiClient::Commons::Types::DelayReasonCode (readonly)

Returns 837i Loop2300, CLM-1300 Box 20 Code indicating the reason why a request was delayed.

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 195

def delay_reason_code
  @delay_reason_code
end

#diagnoses ⇒ Array<CandidApiClient::Diagnoses::Types::DiagnosisCreate> (readonly)

Returns Ideally, this field should contain no more than 12 diagnoses. However, more diagnoses may be submitted at this time, and coders will later prioritize the 12 that will be submitted to the payor.

Returns:

  • (Array<CandidApiClient::Diagnoses::Types::DiagnosisCreate>) —

    Ideally, this field should contain no more than 12 diagnoses. However, more diagnoses may be submitted at this time, and coders will later prioritize the 12 that will be submitted to the payor.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 77

def diagnoses
  @diagnoses
end

#discharge_date ⇒ Date (readonly)

Returns 837p Loop2300 DTP*096, CMS-1500 Box 18 Required for inpatient claims when the patient was discharged from the facility and the discharge date is known.

Returns:

  • (Date) —

    837p Loop2300 DTP*096, CMS-1500 Box 18 Required for inpatient claims when the patient was discharged from the facility and the discharge date is known.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 181

def discharge_date
  @discharge_date
end

#end_date_of_service ⇒ Date (readonly)

Returns Date formatted as YYYY-MM-DD; eg: 2019-08-25. This date must be the local date in the timezone where the service occurred. If omitted, the Encounter is assumed to be for a single day. Must not be temporally before the date_of_service field. If there are greater than zero service lines, it is recommended to specify end_date_of_service on the service_line instead of on the encounter to prepare for future API versions.

Returns:

  • (Date) —

    Date formatted as YYYY-MM-DD; eg: 2019-08-25. This date must be the local date in the timezone where the service occurred. If omitted, the Encounter is assumed to be for a single day. Must not be temporally before the date_of_service field. If there are greater than zero service lines, it is recommended to specify end_date_of_service on the service_line instead of on the encounter to prepare for future API versions.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 125

def end_date_of_service
  @end_date_of_service
end

#existing_medications ⇒ Array<CandidApiClient::Encounters::V4::Types::Medication> (readonly)

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 142

def existing_medications
  @existing_medications
end

#external_claim_submission ⇒ CandidApiClient::ClaimSubmission::V1::Types::ExternalClaimSubmissionCreate (readonly)

Returns To be included for claims that have been submitted outside of Candid. Candid supports posting remits and payments to these claims and working them in-platform (e.g. editing, resubmitting).

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 97

def external_claim_submission
  @external_claim_submission
end

#external_id ⇒ String (readonly)

Returns A client-specified unique ID to associate with this encounter; for example, your internal encounter ID or a Dr. Chrono encounter ID. This field should not contain PHI.

Returns:

  • (String) —

    A client-specified unique ID to associate with this encounter; for example, your internal encounter ID or a Dr. Chrono encounter ID. This field should not contain PHI.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 107

def external_id
  @external_id
end

#initial_referring_provider ⇒ CandidApiClient::EncounterProviders::V2::Types::InitialReferringProvider (readonly)

Returns The second iteration of Loop ID-2310. Use code “P3 - Primary Care Provider” in this loop to indicate the initial referral from the primary care provider or whatever provider wrote the initial referral for this patient’s episode of care being billed/reported in this transaction.

Returns:

  • (CandidApiClient::EncounterProviders::V2::Types::InitialReferringProvider) —

    The second iteration of Loop ID-2310. Use code “P3 - Primary Care Provider” in this loop to indicate the initial referral from the primary care provider or whatever provider wrote the initial referral for this patient’s episode of care being billed/reported in this transaction.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 58

def initial_referring_provider
  @initial_referring_provider
end

#interventions ⇒ Array<CandidApiClient::Encounters::V4::Types::Intervention> (readonly)

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 146

def interventions
  @interventions
end

#last_menstrual_period_date ⇒ Date (readonly)

Returns 837p Loop2300 DTP*484, CMS-1500 Box 14 Required when, in the judgment of the provider, the services on this claim are related to the patient’s pregnancy.

Returns:

  • (Date) —

    837p Loop2300 DTP*484, CMS-1500 Box 14 Required when, in the judgment of the provider, the services on this claim are related to the patient’s pregnancy.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 192

def last_menstrual_period_date
  @last_menstrual_period_date
end

#onset_of_current_illness_or_symptom_date ⇒ Date (readonly)

Returns 837p Loop2300 DTP*431, CMS-1500 Box 14 Required for the initial medical service or visit performed in response to a medical emergency when the date is available and is different than the date of service. OR This date is the onset of acute symptoms for the current illness or condition.

Returns:

  • (Date) —

    837p Loop2300 DTP*431, CMS-1500 Box 14 Required for the initial medical service or visit performed in response to a medical emergency when the date is available and is different than the date of service. OR This date is the onset of acute symptoms for the current illness or condition.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 188

def onset_of_current_illness_or_symptom_date
  @onset_of_current_illness_or_symptom_date
end

#patient_authorized_release ⇒ Boolean (readonly)

Returns Whether this patient has authorized the release of medical information for billing purpose. Box 12 on the CMS-1500 claim form.

Returns:

  • (Boolean) —

    Whether this patient has authorized the release of medical information for billing purpose. Box 12 on the CMS-1500 claim form.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 129

def patient_authorized_release
  @patient_authorized_release
end

#patient_histories ⇒ Array<CandidApiClient::Encounters::V4::Types::PatientHistoryCategory> (readonly)

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 89

def patient_histories
  @patient_histories
end

#pay_to_address ⇒ CandidApiClient::Commons::Types::StreetAddressLongZip (readonly)

Returns Specifies the address to which payments for the claim should be sent.

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 148

def pay_to_address
  @pay_to_address
end

#place_of_service_code ⇒ CandidApiClient::Commons::Types::FacilityTypeCode (readonly)

Returns Box 24B on the CMS-1500 claim form. 837p Loop2300, CLM-05-1. 02 for telemedicine, 11 for in-person. Full list [here](www.cms .gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 87

def place_of_service_code
  @place_of_service_code
end

#pre_encounter_appointment_ids ⇒ Array<String> (readonly)

Returns:

  • (Array<String>) 


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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 36

def pre_encounter_appointment_ids
  @pre_encounter_appointment_ids
end

#pre_encounter_patient_id ⇒ String (readonly)

Returns:

  • (String) 


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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 34

def pre_encounter_patient_id
  @pre_encounter_patient_id
end

#provider_accepts_assignment ⇒ Boolean (readonly)

Returns Whether you have accepted the patient’s authorization for insurance payments to be made to you, not them. Box 27 on the CMS-1500 claim form.

Returns:

  • (Boolean) —

    Whether you have accepted the patient’s authorization for insurance payments to be made to you, not them. Box 27 on the CMS-1500 claim form.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 137

def provider_accepts_assignment
  @provider_accepts_assignment
end

#rendering_provider ⇒ CandidApiClient::EncounterProviders::V2::Types::RenderingProvider (readonly)

Returns The rendering provider is the practitioner – physician, nurse practitioner, etc. – performing the service. For telehealth services, the rendering provider performs the visit, asynchronous communication, or other service. The rendering provider address should generally be the same as the service facility address.

Returns:

  • (CandidApiClient::EncounterProviders::V2::Types::RenderingProvider) —

    The rendering provider is the practitioner – physician, nurse practitioner, etc. – performing the service. For telehealth services, the rendering provider performs the visit, asynchronous communication, or other service. The rendering provider address should generally be the same as the service facility address.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 52

def rendering_provider
  @rendering_provider
end

#schema_instances ⇒ Array<CandidApiClient::CustomSchemas::V1::Types::SchemaInstance> (readonly)

Returns Key-value pairs that must adhere to a schema created via the Custom Schema API. Multiple schema instances cannot be created for the same schema on an encounter.

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 103

def schema_instances
  @schema_instances
end

#service_authorization_exception_code ⇒ CandidApiClient::Encounters::V4::Types::ServiceAuthorizationExceptionCode (readonly)

Returns 837p Loop2300 REF*4N Required when mandated by government law or regulation to obtain authorization for specific service(s) but, for the reasons listed in one of the enum values of ServiceAuthorizationExceptionCode, the service was performed without obtaining the authorization.

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 171

def service_authorization_exception_code
  @service_authorization_exception_code
end

#service_facility ⇒ CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityBase (readonly)

Returns Encounter Service facility is typically the location a medical service was rendered, such as a provider office or hospital. For telehealth, service facility can represent the provider’s location when the service was delivered (e.g., home), or the location where an in-person visit would have taken place, whichever is easier to identify. If the provider is in-network, service facility may be defined in payer contracts. Box 32 on the CMS-1500 claim form. Note that for an in-network claim to be successfully adjudicated, the service facility address listed on claims must match what was provided to the payer during the credentialing process.

Returns:

  • (CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityBase) —

    Encounter Service facility is typically the location a medical service was rendered, such as a provider office or hospital. For telehealth, service facility can represent the provider’s location when the service was delivered (e.g., home), or the location where an in-person visit would have taken place, whichever is easier to identify. If the provider is in-network, service facility may be defined in payer contracts. Box 32 on the CMS-1500 claim form. Note that for an in-network claim to be successfully adjudicated, the service facility address listed on claims must match what was provided to the payer during the credentialing process.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 71

def service_facility
  @service_facility
end

#service_lines ⇒ Array<CandidApiClient::ServiceLines::V2::Types::ServiceLineCreate> (readonly)

Returns Each service line must be linked to a diagnosis. Concretely, ‘service_line.diagnosis_pointers`must contain at least one entry which should be in bounds of the diagnoses list field.

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 93

def service_lines
  @service_lines
end

#supervising_provider ⇒ CandidApiClient::EncounterProviders::V2::Types::SupervisingProvider (readonly)

Returns Required when the rendering provider is supervised by a physician. If not required by this implementation guide, do not send.

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 61

def supervising_provider
  @supervising_provider
end

#synchronicity ⇒ CandidApiClient::Encounters::V4::Types::SynchronicityType (readonly)

Returns Whether or not this was a synchronous or asynchronous encounter. Asynchronous encounters occur when providers and patients communicate online using forms, instant messaging, or other pre-recorded digital mediums. Synchronous encounters occur in live, real-time settings where the patient interacts directly with the provider, such as over video or a phone call.

Returns:

  • (CandidApiClient::Encounters::V4::Types::SynchronicityType) —

    Whether or not this was a synchronous or asynchronous encounter. Asynchronous encounters occur when providers and patients communicate online using forms, instant messaging, or other pre-recorded digital mediums. Synchronous encounters occur in live, real-time settings where the patient interacts directly with the provider, such as over video or a phone call.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 156

def synchronicity
  @synchronicity
end

#tag_ids ⇒ Array<String> (readonly)

Returns Names of tags that should be on the encounter.

Returns:

  • (Array<String>) —

    Names of tags that should be on the encounter.



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 99

def tag_ids
  @tag_ids
end

#vitals ⇒ CandidApiClient::Encounters::V4::Types::Vitals (readonly)

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 144

def vitals
  @vitals
end

Class Method Details

.from_json(json_object:) ⇒ CandidApiClient::Encounters::V4::Types::EncounterCreateFromPreEncounter

Deserialize a JSON object to an instance of EncounterCreateFromPreEncounter

Parameters:

  • json_object (String)

Returns:



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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 422

def self.from_json(json_object:)
  struct = JSON.parse(json_object, object_class: OpenStruct)
  parsed_json = JSON.parse(json_object)
  pre_encounter_patient_id = struct["pre_encounter_patient_id"]
  pre_encounter_appointment_ids = struct["pre_encounter_appointment_ids"]
  if parsed_json["billing_provider"].nil?
    billing_provider = nil
  else
    billing_provider = parsed_json["billing_provider"].to_json
    billing_provider = CandidApiClient::EncounterProviders::V2::Types::BillingProvider.from_json(json_object: billing_provider)
  end
  if parsed_json["rendering_provider"].nil?
    rendering_provider = nil
  else
    rendering_provider = parsed_json["rendering_provider"].to_json
    rendering_provider = CandidApiClient::EncounterProviders::V2::Types::RenderingProvider.from_json(json_object: rendering_provider)
  end
  if parsed_json["initial_referring_provider"].nil?
    initial_referring_provider = nil
  else
    initial_referring_provider = parsed_json["initial_referring_provider"].to_json
    initial_referring_provider = CandidApiClient::EncounterProviders::V2::Types::InitialReferringProvider.from_json(json_object: initial_referring_provider)
  end
  if parsed_json["supervising_provider"].nil?
    supervising_provider = nil
  else
    supervising_provider = parsed_json["supervising_provider"].to_json
    supervising_provider = CandidApiClient::EncounterProviders::V2::Types::SupervisingProvider.from_json(json_object: supervising_provider)
  end
  if parsed_json["service_facility"].nil?
    service_facility = nil
  else
    service_facility = parsed_json["service_facility"].to_json
    service_facility = CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityBase.from_json(json_object: service_facility)
  end
  diagnoses = parsed_json["diagnoses"]&.map do |item|
    item = item.to_json
    CandidApiClient::Diagnoses::Types::DiagnosisCreate.from_json(json_object: item)
  end
  clinical_notes = parsed_json["clinical_notes"]&.map do |item|
    item = item.to_json
    CandidApiClient::Encounters::V4::Types::ClinicalNoteCategoryCreate.from_json(json_object: item)
  end
  billing_notes = parsed_json["billing_notes"]&.map do |item|
    item = item.to_json
    CandidApiClient::BillingNotes::V2::Types::BillingNoteBase.from_json(json_object: item)
  end
  place_of_service_code = struct["place_of_service_code"]
  patient_histories = parsed_json["patient_histories"]&.map do |item|
    item = item.to_json
    CandidApiClient::Encounters::V4::Types::PatientHistoryCategory.from_json(json_object: item)
  end
  service_lines = parsed_json["service_lines"]&.map do |item|
    item = item.to_json
    CandidApiClient::ServiceLines::V2::Types::ServiceLineCreate.from_json(json_object: item)
  end
  if parsed_json["external_claim_submission"].nil?
    external_claim_submission = nil
  else
    external_claim_submission = parsed_json["external_claim_submission"].to_json
    external_claim_submission = CandidApiClient::ClaimSubmission::V1::Types::ExternalClaimSubmissionCreate.from_json(json_object: external_claim_submission)
  end
  tag_ids = struct["tag_ids"]
  schema_instances = parsed_json["schema_instances"]&.map do |item|
    item = item.to_json
    CandidApiClient::CustomSchemas::V1::Types::SchemaInstance.from_json(json_object: item)
  end
  external_id = struct["external_id"]
  date_of_service = (Date.parse(parsed_json["date_of_service"]) unless parsed_json["date_of_service"].nil?)
  end_date_of_service = unless parsed_json["end_date_of_service"].nil?
                          Date.parse(parsed_json["end_date_of_service"])
                        end
  patient_authorized_release = struct["patient_authorized_release"]
  benefits_assigned_to_provider = struct["benefits_assigned_to_provider"]
  provider_accepts_assignment = struct["provider_accepts_assignment"]
  appointment_type = struct["appointment_type"]
  existing_medications = parsed_json["existing_medications"]&.map do |item|
    item = item.to_json
    CandidApiClient::Encounters::V4::Types::Medication.from_json(json_object: item)
  end
  if parsed_json["vitals"].nil?
    vitals = nil
  else
    vitals = parsed_json["vitals"].to_json
    vitals = CandidApiClient::Encounters::V4::Types::Vitals.from_json(json_object: vitals)
  end
  interventions = parsed_json["interventions"]&.map do |item|
    item = item.to_json
    CandidApiClient::Encounters::V4::Types::Intervention.from_json(json_object: item)
  end
  if parsed_json["pay_to_address"].nil?
    pay_to_address = nil
  else
    pay_to_address = parsed_json["pay_to_address"].to_json
    pay_to_address = CandidApiClient::Commons::Types::StreetAddressLongZip.from_json(json_object: pay_to_address)
  end
  synchronicity = struct["synchronicity"]
  billable_status = struct["billable_status"]
  additional_information = struct["additional_information"]
  service_authorization_exception_code = struct["service_authorization_exception_code"]
  admission_date = (Date.parse(parsed_json["admission_date"]) unless parsed_json["admission_date"].nil?)
  discharge_date = (Date.parse(parsed_json["discharge_date"]) unless parsed_json["discharge_date"].nil?)
  onset_of_current_illness_or_symptom_date = unless parsed_json["onset_of_current_illness_or_symptom_date"].nil?
                                               Date.parse(parsed_json["onset_of_current_illness_or_symptom_date"])
                                             end
  last_menstrual_period_date = unless parsed_json["last_menstrual_period_date"].nil?
                                 Date.parse(parsed_json["last_menstrual_period_date"])
                               end
  delay_reason_code = struct["delay_reason_code"]
  new(
    pre_encounter_patient_id: pre_encounter_patient_id,
    pre_encounter_appointment_ids: pre_encounter_appointment_ids,
    billing_provider: billing_provider,
    rendering_provider: rendering_provider,
    initial_referring_provider: initial_referring_provider,
    supervising_provider: supervising_provider,
    service_facility: service_facility,
    diagnoses: diagnoses,
    clinical_notes: clinical_notes,
    billing_notes: billing_notes,
    place_of_service_code: place_of_service_code,
    patient_histories: patient_histories,
    service_lines: service_lines,
    external_claim_submission: external_claim_submission,
    tag_ids: tag_ids,
    schema_instances: schema_instances,
    external_id: external_id,
    date_of_service: date_of_service,
    end_date_of_service: end_date_of_service,
    patient_authorized_release: patient_authorized_release,
    benefits_assigned_to_provider: benefits_assigned_to_provider,
    provider_accepts_assignment: provider_accepts_assignment,
    appointment_type: appointment_type,
    existing_medications: existing_medications,
    vitals: vitals,
    interventions: interventions,
    pay_to_address: pay_to_address,
    synchronicity: synchronicity,
    billable_status: billable_status,
    additional_information: additional_information,
    service_authorization_exception_code: service_authorization_exception_code,
    admission_date: admission_date,
    discharge_date: discharge_date,
    onset_of_current_illness_or_symptom_date: onset_of_current_illness_or_symptom_date,
    last_menstrual_period_date: last_menstrual_period_date,
    delay_reason_code: delay_reason_code,
    additional_properties: struct
  )
end

.validate_raw(obj:) ⇒ Void

Leveraged for Union-type generation, validate_raw attempts to parse the given

hash and check each fields type against the current object's property
definitions.

Parameters:

  • obj (Object)

Returns:

  • (Void) 


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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 585

def self.validate_raw(obj:)
  obj.pre_encounter_patient_id.is_a?(String) != false || raise("Passed value for field obj.pre_encounter_patient_id is not the expected type, validation failed.")
  obj.pre_encounter_appointment_ids.is_a?(Array) != false || raise("Passed value for field obj.pre_encounter_appointment_ids is not the expected type, validation failed.")
  CandidApiClient::EncounterProviders::V2::Types::BillingProvider.validate_raw(obj: obj.billing_provider)
  CandidApiClient::EncounterProviders::V2::Types::RenderingProvider.validate_raw(obj: obj.rendering_provider)
  obj.initial_referring_provider.nil? || CandidApiClient::EncounterProviders::V2::Types::InitialReferringProvider.validate_raw(obj: obj.initial_referring_provider)
  obj.supervising_provider.nil? || CandidApiClient::EncounterProviders::V2::Types::SupervisingProvider.validate_raw(obj: obj.supervising_provider)
  obj.service_facility.nil? || CandidApiClient::ServiceFacility::Types::EncounterServiceFacilityBase.validate_raw(obj: obj.service_facility)
  obj.diagnoses.is_a?(Array) != false || raise("Passed value for field obj.diagnoses is not the expected type, validation failed.")
  obj.clinical_notes&.is_a?(Array) != false || raise("Passed value for field obj.clinical_notes is not the expected type, validation failed.")
  obj.billing_notes&.is_a?(Array) != false || raise("Passed value for field obj.billing_notes is not the expected type, validation failed.")
  obj.place_of_service_code.is_a?(CandidApiClient::Commons::Types::FacilityTypeCode) != false || raise("Passed value for field obj.place_of_service_code is not the expected type, validation failed.")
  obj.patient_histories&.is_a?(Array) != false || raise("Passed value for field obj.patient_histories is not the expected type, validation failed.")
  obj.service_lines&.is_a?(Array) != false || raise("Passed value for field obj.service_lines is not the expected type, validation failed.")
  obj.external_claim_submission.nil? || CandidApiClient::ClaimSubmission::V1::Types::ExternalClaimSubmissionCreate.validate_raw(obj: obj.external_claim_submission)
  obj.tag_ids&.is_a?(Array) != false || raise("Passed value for field obj.tag_ids is not the expected type, validation failed.")
  obj.schema_instances&.is_a?(Array) != false || raise("Passed value for field obj.schema_instances is not the expected type, validation failed.")
  obj.external_id.is_a?(String) != false || raise("Passed value for field obj.external_id is not the expected type, validation failed.")
  obj.date_of_service&.is_a?(Date) != false || raise("Passed value for field obj.date_of_service is not the expected type, validation failed.")
  obj.end_date_of_service&.is_a?(Date) != false || raise("Passed value for field obj.end_date_of_service is not the expected type, validation failed.")
  obj.patient_authorized_release.is_a?(Boolean) != false || raise("Passed value for field obj.patient_authorized_release is not the expected type, validation failed.")
  obj.benefits_assigned_to_provider.is_a?(Boolean) != false || raise("Passed value for field obj.benefits_assigned_to_provider is not the expected type, validation failed.")
  obj.provider_accepts_assignment.is_a?(Boolean) != false || raise("Passed value for field obj.provider_accepts_assignment is not the expected type, validation failed.")
  obj.appointment_type&.is_a?(String) != false || raise("Passed value for field obj.appointment_type is not the expected type, validation failed.")
  obj.existing_medications&.is_a?(Array) != false || raise("Passed value for field obj.existing_medications is not the expected type, validation failed.")
  obj.vitals.nil? || CandidApiClient::Encounters::V4::Types::Vitals.validate_raw(obj: obj.vitals)
  obj.interventions&.is_a?(Array) != false || raise("Passed value for field obj.interventions is not the expected type, validation failed.")
  obj.pay_to_address.nil? || CandidApiClient::Commons::Types::StreetAddressLongZip.validate_raw(obj: obj.pay_to_address)
  obj.synchronicity&.is_a?(CandidApiClient::Encounters::V4::Types::SynchronicityType) != false || raise("Passed value for field obj.synchronicity is not the expected type, validation failed.")
  obj.billable_status.is_a?(CandidApiClient::Encounters::V4::Types::BillableStatusType) != false || raise("Passed value for field obj.billable_status is not the expected type, validation failed.")
  obj.additional_information&.is_a?(String) != false || raise("Passed value for field obj.additional_information is not the expected type, validation failed.")
  obj.service_authorization_exception_code&.is_a?(CandidApiClient::Encounters::V4::Types::ServiceAuthorizationExceptionCode) != false || raise("Passed value for field obj.service_authorization_exception_code is not the expected type, validation failed.")
  obj.admission_date&.is_a?(Date) != false || raise("Passed value for field obj.admission_date is not the expected type, validation failed.")
  obj.discharge_date&.is_a?(Date) != false || raise("Passed value for field obj.discharge_date is not the expected type, validation failed.")
  obj.onset_of_current_illness_or_symptom_date&.is_a?(Date) != false || raise("Passed value for field obj.onset_of_current_illness_or_symptom_date is not the expected type, validation failed.")
  obj.last_menstrual_period_date&.is_a?(Date) != false || raise("Passed value for field obj.last_menstrual_period_date is not the expected type, validation failed.")
  obj.delay_reason_code&.is_a?(CandidApiClient::Commons::Types::DelayReasonCode) != false || raise("Passed value for field obj.delay_reason_code is not the expected type, validation failed.")
end

Instance Method Details

#to_json(*_args) ⇒ String

Serialize an instance of EncounterCreateFromPreEncounter to a JSON object

Returns:

  • (String) 


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# File 'lib/candidhealth/encounters/v_4/types/encounter_create_from_pre_encounter.rb', line 575

def to_json(*_args)
  @_field_set&.to_json
end