Class: ChangeHealth::Response::EligibilityBenefit

Inherits:
Hash
  • Object
show all
Includes:
Hashie::Extensions::IndifferentAccess, Hashie::Extensions::MergeInitializer
Defined in:
lib/change_health/response/eligibility/eligibility_benefit.rb

Constant Summary collapse

OUT_OF_POCKET = 
'G'
COPAYMENT = 
'B'
COINSURANCE = 
'A'
NON_COVERED = 
'I'
DEDUCTIBLE = 
'C'
INDIVIDUAL = 
'IND'
CHILD = 
'CHD'
EMPLOYEE = 
'EMP'
FAMILY = 
'FAM'
EMPLOYEE_AND_CHILD = 
'ECH'
EMPLOYEE_AND_SPOUSE = 
'ESP'
VISIT = 
'27'
SERVICE_YEAR = 
'22'
YEAR = 
'23'
YTD = 
'24'
DAY = 
'7'
REMAINING = 
'29'
CODES = 
{
  out_of_pocket: OUT_OF_POCKET,
  copayment: COPAYMENT,
  coinsurance: COINSURANCE,
  non_covered: NON_COVERED,
  deductible: DEDUCTIBLE
}
COVERAGES = 
{
  individual: INDIVIDUAL,
  child: CHILD,
  employee: EMPLOYEE,
  family: FAMILY,
  employee_and_child: EMPLOYEE_AND_CHILD,
  employee_and_spouse: EMPLOYEE_AND_SPOUSE
}
TIMEFRAMES = 
{
  visit: VISIT,
  year: YEAR,
  remaining: REMAINING
}
MEDICARE = 
{
  part_a: 'MA',
  part_b: 'MB',
  primary: 'MP'
}
HELPERS = 
{
  timeQualifierCode: TIMEFRAMES,
  coverageLevelCode: COVERAGES,
  code: CODES
}

Instance Method Summary collapse

Instance Method Details

#amount ⇒ Object 



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# File 'lib/change_health/response/eligibility/eligibility_benefit.rb', line 98

def amount
  self.coinsurance? ? self.benefitPercent : self.benefitAmount
end

#descriptions ⇒ Object 



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# File 'lib/change_health/response/eligibility/eligibility_benefit.rb', line 86

def descriptions
  data = self.additionalInformation || []

  data.map {|info| info['description'] }.compact
end

#in_plan_network? ⇒ Boolean Also known as: in_plan?, in_network?

Returns:

  • (Boolean) 


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# File 'lib/change_health/response/eligibility/eligibility_benefit.rb', line 92

def in_plan_network?
  return 'Y' == self[:inPlanNetworkIndicatorCode] || self[:inPlanNetworkIndicatorCode].nil? && self.medicare?
end

#medicare? ⇒ Boolean

Returns:

  • (Boolean) 


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# File 'lib/change_health/response/eligibility/eligibility_benefit.rb', line 66

def medicare?
  MEDICARE.values.include?(self.insuranceTypeCode)
end

#plan_date_range ⇒ Object 



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# File 'lib/change_health/response/eligibility/eligibility_benefit.rb', line 117

def plan_date_range
  pd = self.date_info&.dig('plan') || ''
  pd.split('-')
end

#plan_date_range_end ⇒ Object 



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# File 'lib/change_health/response/eligibility/eligibility_benefit.rb', line 126

def plan_date_range_end
  ChangeHealth::Models::PARSE_DATE.call(self.plan_date_range[1])
end

#plan_date_range_start ⇒ Object 



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# File 'lib/change_health/response/eligibility/eligibility_benefit.rb', line 122

def plan_date_range_start
  ChangeHealth::Models::PARSE_DATE.call(self.plan_date_range[0])
end

#services ⇒ Object 



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# File 'lib/change_health/response/eligibility/eligibility_benefit.rb', line 102

def services
  self['serviceTypeCodes']&.each_with_index&.map {|stc, i| [stc, self['serviceTypes']&.at(i)]} || []
end