Trizetto::Api

gem 'trizetto-api'

# Savon-multipart is used in the CORE II API. savon-multipart 2.1.1 has the
# mail gem, pinned to exactly 2.5.4.  As of Jan 18, 2018, there is an
# unreleased version that uses ~> 2.6.  Depending on your existing gems
# you may need to add an explicit dependency on savon-multipart if bundle
# install fails with a mail gem dependency.
#
# You can savon-multipart, or use git diretly with one of the below
#
# savon-multipart as of Jan 18, 2018:
# gem 'savon-multipart', git: "git@github.com:savonrb/savon-multipart.git", ref: 'd9a138b6c166cd7c30c28e8888ff19011f8ec071'
#
# live on the edge
# gem 'savon-multipart', git: "git@github.com:savonrb/savon-multipart.git", branch: :master
#
# Your fork?
# gem 'savon-multipart', git: "git@github.com:YOU/savon-multipart.git"

response = client.do_inquiry({...})
response.active_coverage_for?(service_type_code = "30")  #=> true | false

require 'trizetto/api'

Trizetto::Api.configure do |config|
  config.username = ENV['TRIZETTO_USERNAME']
  config.password = ENV['TRIZETTO_PASSWORD']
end

client = Trizetto::Api::Eligibility::WebService::Client.new({
  # You probably don't want logging enable unless you are being very careful to protect PHI in logs
  # pretty_print_xml: true,
  # log: true,
  # log_level: :debug,
})

response = client.do_inquiry({
  'ProviderLastName': 'YOUR_COMPANY_NAME',
  'NPI':              'YOUR NPI HERE',
  'InsuredFirstName': 'Mickey',
  'InsuredLastName':  'Mouse',
  'InsuredDob':       '19281118',
  'GediPayerId':      'N4222',
})



# Were there validation errors with the request?
response.success?                                          # => false
response.success_code                                      # => "ValidationFailure"
response.errors.messages                                   # => ["Please enter InsuranceNum."]
response.errors.validation_failures.first.affected_fields  # => ["InsuranceNum"]
response.errors.validation_failures.first.message          # => "Please enter InsuranceNum."


# Did we successfully get back an eligibility response from the payer.
response.success?                   # => true
response.success_code               # => "Success"
response.transaction_id             # => "c6eb40c5584f0496be3f3a48d0ddfd"
response.trace_number               # => "88213481"
response.payer_name                 # => "BLUE CROSS BLUE SHIELD OF MASSACHUSETTS"
response.active_coverage_for?("30") # => true

# Did the response have group number for the subscriber or dependent?
response.subscriber&.group_number || response.dependent&.group_number  # => "999999999A6AG999"

# What is the subscriber's member number?
response.subscriber.id  # => "XXP123456789"

# Was the response rejected? We got back an eligibility response, but probably the patient wasn't found
response.success?                          # => true
response.success_code                      # => "Success"
response.active_coverage_for?("30")        # => false
response.rejected?                         # => true
response.rejections.count                  # => 1
response.rejections.first.reason           # => "Patient Birth Date Does Not Match That for the Patient on the Database"
response.rejections.first.follow_up_action # => "Please Correct and Resubmit"

# What active insurance coverages of service_type_code=30 does this patient have?
coverages = response.patient.benefits.select {|benefit| benefit.active_coverage? && benefit.service_type_codes.include?("30")}
coverages.count                # => 2
coverages.first.insurance_type # => "Preferred Provider Organization (PPO)"
coverages.last.insurance_type  # => "Medicare Part A"
coverages.first.messages       # => nil
coverages.last.messages        # => ["BCBSMA IS PRIME"]

# Find all the benefit information for service_type_code=30
benefits = response.patient.benefits.select {|benefit| benefit.service_type_codes.include?("30")}

benefits.map(&:info).uniq # => ["Active Coverage", "Deductible", "Coverage Basis", "Out of Pocket (Stop Loss)", "Services Restricted to Following Provider"]

require 'trizetto/api'

Trizetto::Api.configure do |config|
  config.username = ENV['TRIZETTO_USERNAME']
  config.password = ENV['TRIZETTO_PASSWORD']
end


client = Trizetto::Api::Eligibility::Core2.new
client.check_eligibility(payload: x12_message)

require 'trizetto/api'

Trizetto::Api.configure do |config|
  config.username = ENV['TRIZETTO_USERNAME']
  config.password = ENV['TRIZETTO_PASSWORD']
end

client = Trizetto::Api::PayerList::WebService.new({
  pretty_print_xml: true,
  log: true,
  log_level: :debug,
})

response = client.ping

require 'trizetto/api'

Trizetto::Api.configure do |config|
  config.username = ENV['TRIZETTO_USERNAME']
  config.password = ENV['TRIZETTO_PASSWORD']
end

client = Trizetto::Api::PayerList::WebService.new({
  pretty_print_xml: true,
  log: true,
  log_level: :debug,
  read_timeout: 60*5 # 5 minutes
})

response = client.payer_list