Class: ChangeHealth::Response::Claim::Report277Data

Inherits:
ReportData show all
Defined in:
lib/change_health/response/claim/report/report_277_data.rb

Overview

Methods only return meaningful data for json reports

Instance Attribute Summary

Attributes inherited from ReportData

#json, #report_name

Attributes inherited from ResponseData

#raw, #response

Instance Method Summary collapse

Methods inherited from ReportData

#edi?, #initialize, #is_277?, is_277?, is_835?, #is_835?, #presence, report_type, #report_type

Methods inherited from ResponseData

#errors, #errors?, #initialize, #recommend_retry?, #request_body, #server_error

Constructor Details

This class inherits a constructor from ChangeHealth::Response::Claim::ReportData

Instance Method Details

#claims ⇒ Object

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# File 'lib/change_health/response/claim/report/report_277_data.rb', line 28

def claims
  report_claims = []

  transactions&.each do |transaction|
    id = transaction['id']
    report_creation_date = ChangeHealth::Models::PARSE_DATE.call(transaction['transactionSetCreationDate'])

    transaction['payers']&.each do |payer|
      payer_identification = payer['payerIdentification']
      payer_name = payer['organizationName']
      payer['claimStatusTransactions']&.each do |claim_status_txn|
        claim_status_txn['claimStatusDetails']&.each do |claim_status_detail|
          service_provider_npi = claim_status_detail.dig('serviceProvider', 'npi')
          claim_status_detail['patientClaimStatusDetails']&.each do |patient_claim_status_detail|
            patient_first_name = patient_claim_status_detail.dig('subscriber', 'firstName')
            patient_last_name = patient_claim_status_detail.dig('subscriber', 'lastName')
            patient_member_id = patient_claim_status_detail.dig('subscriber', 'memberId')

            patient_claim_status_detail['claims']&.each do |claim|
              report_claim_args = parse_patient_claim(claim)

              next if report_claim_args.nil?

              report_claims << Report277Claim.new(
                id: id,
                patient_first_name: patient_first_name,
                patient_last_name: patient_last_name,
                patient_member_id: patient_member_id,
                payer_identification: payer_identification,
                payer_name: payer_name,
                report_creation_date: report_creation_date,
                report_name: report_name,
                service_provider_npi: service_provider_npi,
                **report_claim_args
              )
            end
          end
        end
      end
    end
  end

  report_claims
end

#parse_patient_claim(claim) ⇒ Object

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# File 'lib/change_health/response/claim/report/report_277_data.rb', line 82

def parse_patient_claim(claim)
  procedure_codes = []
  claim['serviceLines']&.each do |service_line|
    procedure_codes << service_line.dig('service', 'procedureCode')
  end
  claim_status = claim['claimStatus']
  return if claim_status.nil?

  clearinghouse_trace_number = claim_status['clearinghouseTraceNumber']
   = claim_status['patientAccountNumber']
  referenced_transaction_trace_number = claim_status['referencedTransactionTraceNumber']
  trading_partner_claim_number = claim_status['tradingPartnerClaimNumber']

  service_date_begin = ChangeHealth::Models::PARSE_DATE.call(
    presence(claim_status['claimServiceBeginDate']) || presence(claim_status['claimServiceDate'])
  )
  service_date_end = ChangeHealth::Models::PARSE_DATE.call(
    presence(claim_status['claimServiceEndDate']) || presence(claim_status['claimServiceDate'])
  )

  info_claim_statuses = []
  claim_status['informationClaimStatuses']&.each do |info_claim_status|
    message = info_claim_status['message']
    status_information_effective_date = ChangeHealth::Models::PARSE_DATE.call(info_claim_status['statusInformationEffectiveDate'])
    total_charge_amount = info_claim_status['totalClaimChargeAmount']

    info_statuses = []
    info_claim_status['informationStatuses']&.each do |info_status|
      info_statuses << Report277InfoStatus.new(
        status_category_code: info_status['healthCareClaimStatusCategoryCode'],
        status_category_code_value: info_status['healthCareClaimStatusCategoryCodeValue'],
        status_code: info_status['statusCode'],
        status_code_value: info_status['statusCodeValue']
      )
    end

    info_claim_statuses << Report277InfoClaimStatus.new(
      message: message,
      info_statuses: info_statuses,
      total_charge_amount: total_charge_amount,
      status_information_effective_date: status_information_effective_date
    )
  end

  {
    clearinghouse_trace_number: clearinghouse_trace_number,
    info_claim_statuses: info_claim_statuses,
    patient_account_number: ,
    procedure_codes: procedure_codes,
    referenced_transaction_trace_number: referenced_transaction_trace_number,
    service_date_begin: service_date_begin,
    service_date_end: service_date_end,
    trading_partner_claim_number: trading_partner_claim_number
  }
end

#payer_name ⇒ Object

Only one payer per report



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# File 'lib/change_health/response/claim/report/report_277_data.rb', line 13

def payer_name
  payers = transactions&.first&.dig('payers')

  payers&.first&.dig('organizationName')
end

#report_creation_date ⇒ Object 



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# File 'lib/change_health/response/claim/report/report_277_data.rb', line 19

def report_creation_date
  ChangeHealth::Models::PARSE_DATE.call(transactions&.first&.dig('transactionSetCreationDate'))
end

#transactions ⇒ Object 



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# File 'lib/change_health/response/claim/report/report_277_data.rb', line 8

def transactions
  @raw['transactions']
end