Class: CandidApiClient::EncountersUniversal::Types::UniversalEncounterCreateFromPreEncounterBase

Inherits:
Object
  • Object
show all
Defined in:
lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.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:, 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, 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, interventions: OMIT, pay_to_address: OMIT, synchronicity: OMIT, vitals: 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::EncountersUniversal::Types::UniversalEncounterCreateFromPreEncounterBase

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 or Form Locator 1 on a UB-04 claim form.

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

    The second iteration of Loop ID-2310 on an 837P form. 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. Not used in an 837i claim

  • 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. There is no equivalent on the paper UB-04 claim form, but this field is equivalent to Loop 2310E Service Facility Location details on an 837i form, and is used when this is different to the entity identified as the Billing Provider. Note that for an in-network claim to be successfully adjudicated, the service facility address listed

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

    Holds a collection of clinical observations made by healthcare providers during patient encounters. Please note that medical records for appeals should be sent using the Encounter Attachments API.

  • 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.

  • patient_histories (Array<CandidApiClient::Encounters::V4::Types::PatientHistoryCategory>) (defaults to: OMIT)
  • 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 or Form Locator 45 on the UB-04 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 or Form Locator 52 on a UB-04 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 or Form Locator 53 on a UB-04 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. There is no exact equivalent of this field on a UB-04 claim, however contributes to the concept of Form Locator 53.

  • 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)
  • 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.

  • vitals (CandidApiClient::Encounters::V4::Types::Vitals) (defaults to: OMIT)
  • 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 or Form Locator 80 on a UB-04 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 or UB-04 Form Locator 12. 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. Not used on an institutional claim.

  • 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. For UB-04 claims, this is populated separately via occurrence codes.

  • 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. This field is populated separately via occurrence codes for UB-04 claim forms.

  • 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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 308

def initialize(pre_encounter_patient_id:, pre_encounter_appointment_ids:, billing_provider:, 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, 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, interventions: OMIT, pay_to_address: OMIT, synchronicity: OMIT, vitals: 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
  @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
  @clinical_notes = clinical_notes if clinical_notes != OMIT
  @billing_notes = billing_notes if billing_notes != OMIT
  @patient_histories = patient_histories if patient_histories != 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
  @interventions = interventions if interventions != OMIT
  @pay_to_address = pay_to_address if pay_to_address != OMIT
  @synchronicity = synchronicity if synchronicity != OMIT
  @vitals = vitals if vitals != 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,
    "initial_referring_provider": initial_referring_provider,
    "supervising_provider": supervising_provider,
    "service_facility": service_facility,
    "clinical_notes": clinical_notes,
    "billing_notes": billing_notes,
    "patient_histories": patient_histories,
    "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,
    "interventions": interventions,
    "pay_to_address": pay_to_address,
    "synchronicity": synchronicity,
    "vitals": vitals,
    "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 or Form Locator 80 on a UB-04 claim form.

Returns:

  • (String) —

    Defines additional information on the claim needed by the payer. Box 19 on the CMS-1500 claim form or Form Locator 80 on a UB-04 claim form.



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 145

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 180

def additional_properties
  @additional_properties
end

#admission_date ⇒ Date (readonly)

Returns 837p Loop2300 DTP*435, CMS-1500 Box 18 or UB-04 Form Locator 12. 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 or UB-04 Form Locator 12. 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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 158

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 121

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 or Form Locator 53 on a UB-04 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 or Form Locator 53 on a UB-04 claim form.



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 113

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 142

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 71

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 or Form Locator 1 on a UB-04 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 or Form Locator 1 on a UB-04 claim form.



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 42

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. Please note that medical records for appeals should be sent using the Encounter Attachments API.

Returns:



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 68

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 or Form Locator 45 on the UB-04 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 or Form Locator 45 on the UB-04 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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 97

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 178

def delay_reason_code
  @delay_reason_code
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. Not used on an institutional claim.

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. Not used on an institutional claim.



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 162

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 105

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 123

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 77

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 87

def external_id
  @external_id
end

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

Returns The second iteration of Loop ID-2310 on an 837P form. 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. Not used in an 837i claim.

Returns:

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

    The second iteration of Loop ID-2310 on an 837P form. 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. Not used in an 837i claim



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 49

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 125

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. This field is populated separately via occurrence codes for UB-04 claim forms.

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. This field is populated separately via occurrence codes for UB-04 claim forms.



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 175

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. For UB-04 claims, this is populated separately via occurrence codes.

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. For UB-04 claims, this is populated separately via occurrence codes.



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 170

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 or Form Locator 52 on a UB-04 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 or Form Locator 52 on a UB-04 claim form.



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 109

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 73

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 127

def pay_to_address
  @pay_to_address
end

#pre_encounter_appointment_ids ⇒ Array<String> (readonly)

Returns:

  • (Array<String>) 


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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 31

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 29

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. There is no exact equivalent of this field on a UB-04 claim, however contributes to the concept of Form Locator 53.

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. There is no exact equivalent of this field on a UB-04 claim, however contributes to the concept of Form Locator 53.



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 118

def provider_accepts_assignment
  @provider_accepts_assignment
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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 83

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 152

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. There is no equivalent on the paper UB-04 claim form, but this field is equivalent to Loop 2310E Service Facility Location details on an 837i form, and is used when this is different to the entity identified as the Billing Provider. Note that for an in-network claim to be successfully adjudicated, the service facility address listed.

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. There is no equivalent on the paper UB-04 claim form, but this field is equivalent to Loop 2310E Service Facility Location details on an 837i form, and is used when this is different to the entity identified as the Billing Provider. Note that for an in-network claim to be successfully adjudicated, the service facility address listed



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 64

def service_facility
  @service_facility
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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 52

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 135

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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 79

def tag_ids
  @tag_ids
end

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

Returns:



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 137

def vitals
  @vitals
end

Class Method Details

.from_json(json_object:) ⇒ CandidApiClient::EncountersUniversal::Types::UniversalEncounterCreateFromPreEncounterBase

Deserialize a JSON object to an instance of

UniversalEncounterCreateFromPreEncounterBase

Parameters:

  • json_object (String)

Returns:



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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 390

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["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
  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
  patient_histories = parsed_json["patient_histories"]&.map do |item|
    item = item.to_json
    CandidApiClient::Encounters::V4::Types::PatientHistoryCategory.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
  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"]
  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
  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,
    initial_referring_provider: initial_referring_provider,
    supervising_provider: supervising_provider,
    service_facility: service_facility,
    clinical_notes: clinical_notes,
    billing_notes: billing_notes,
    patient_histories: patient_histories,
    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,
    interventions: interventions,
    pay_to_address: pay_to_address,
    synchronicity: synchronicity,
    vitals: vitals,
    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_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 535

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)
  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.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.patient_histories&.is_a?(Array) != false || raise("Passed value for field obj.patient_histories 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.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.vitals.nil? || CandidApiClient::Encounters::V4::Types::Vitals.validate_raw(obj: obj.vitals)
  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 UniversalEncounterCreateFromPreEncounterBase to a JSON

object

Returns:

  • (String) 


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# File 'lib/candidhealth/encounters_universal/types/universal_encounter_create_from_pre_encounter_base.rb', line 525

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