Merge pull request #21 from affect-therapeutics/rpo/add-ts3-support

Adds PER support to the claim loop

edi_835_parser/elements/contact_communication_number_qualifier.py

@@ -0,0 +1,14 @@
+from edi_835_parser.elements import Element
+
+contact_communication_number_qualifer = {
+	'FX': 'fax',
+	'TE': 'phone',
+	'EM': 'email',
+	'UR': 'url',
+	'EX': 'ext',
+}
+
+
+class ContactCommunicationNumberQualifier(Element):
+	def parser(self, value: str) -> str:
+		return contact_communication_number_qualifer.get(value, value)

edi_835_parser/loops/claim.py

@@ -6,6 +6,7 @@
 from edi_835_parser.segments.date import Date as DateSegment
 from edi_835_parser.segments.amount import Amount as AmountSegment
 from edi_835_parser.segments.utilities import find_identifier
+from edi_835_parser.segments.payer_contact import PayerContact as PayerContactSegment
 from edi_835_parser.segments.inpatient_adjudication import (
 	InpatientAdjudication as InpatientAdjudicationSegment,
 )
@@ -51,6 +52,7 @@ def __init__(
 		self.inpatient = inpatient
 		self.outpatient = outpatient
 		self.adjustments = adjustments if adjustments else []
+		self.contacts = []
 
 	def __repr__(self):
 		return '\n'.join(str(item) for item in self.__dict__.items())
@@ -135,6 +137,13 @@ def coverage_amount(self):
 				return amount.amount
 		return None
 
+	@property
+	def claim_payer_contact(self):
+		for contact in self.contacts:
+			if contact.code == 'payers_claim_office':
+				return contact
+		return None
+
 	@classmethod
 	def build(
 		cls, segment: str, segments: Iterator[str]
@@ -174,6 +183,11 @@ def build(
 					claim.amounts.append(amount)
 					segment = None
 
+				elif identifier == PayerContactSegment.identification:
+					contact = PayerContactSegment(segment)
+					claim.contacts.append(contact)
+					segment = None
+
 				elif identifier == InpatientAdjudicationSegment.identification:
 					inpatient = InpatientAdjudicationSegment(segment)
 					claim.inpatient = inpatient
@@ -193,8 +207,8 @@ def build(
 					return claim, segments, segment
 
 				else:
+					message = f'Identifier: {identifier} not handled in claim loop.  {segment}'
 					segment = None
-					message = f'Identifier: {identifier} not handled in claim loop.'
 					Logger.logr.warning(message)
 
 			except StopIteration:

edi_835_parser/loops/organization.py

@@ -83,8 +83,10 @@ def build(
 					return organization, segments, segment
 
 				else:
+					message = (
+						f'Identifier: {identifier} not handled in organization loop.  {segment}'
+					)
 					segment = None
-					message = f'Identifier: {identifier} not handled in organization loop.'
 					Logger.logr.warning(message)
 
 			except StopIteration:

edi_835_parser/loops/service.py

@@ -143,7 +143,7 @@ def build(
 					return service, segment, segments
 
 				else:
-					message = f'Identifier: {identifier} not handled in service loop.'
+					message = f'Identifier: {identifier} not handled in service loop.  {segment}'
 					Logger.logr.warning(message)
 
 			except StopIteration:

edi_835_parser/segments/payer_contact.py

@@ -1,3 +1,6 @@
+from edi_835_parser.elements.contact_communication_number_qualifier import (
+	ContactCommunicationNumberQualifier,
+)
 from edi_835_parser.elements.identifier import Identifier
 from edi_835_parser.elements.contact_function_code import ContactFunctionCode
 from edi_835_parser.segments.utilities import split_segment, get_element
@@ -8,6 +11,9 @@ class PayerContact:
 
 	identifier = Identifier()
 	code = ContactFunctionCode()
+	communication_no_or_url_qualifier = ContactCommunicationNumberQualifier()
+	communication_no_or_url_qualifier_2 = ContactCommunicationNumberQualifier()
+	communication_no_or_url_qualifier_3 = ContactCommunicationNumberQualifier()
 
 	def __init__(self, segment: str):
 		self.index = segment.split(':', 1)[0]
@@ -19,8 +25,63 @@ def __init__(self, segment: str):
 		self.identifier = segment[0]
 		self.code = segment[1]
 		self.name = get_element(segment, 2)
+
 		self.communication_no_or_url_qualifier = get_element(segment, 3)
 		self.communication_no_or_url = get_element(segment, 4)
+		self.communication_no_or_url_qualifier_2 = get_element(segment, 5)
+		self.communication_no_or_url_2 = get_element(segment, 6)
+		self.communication_no_or_url_qualifier_3 = get_element(segment, 7)
+		self.communication_no_or_url_3 = get_element(segment, 8)
+
+		self._comm_groups = [
+			(self.communication_no_or_url_qualifier, self.communication_no_or_url),
+			(self.communication_no_or_url_qualifier_2, self.communication_no_or_url_2),
+			(self.communication_no_or_url_qualifier_3, self.communication_no_or_url_3),
+		]
+
+	@property
+	def phone_number(self):
+		num = ''
+		ext = ''
+		for i, (qualifier, number) in enumerate(self._comm_groups):
+			if qualifier == 'phone':
+				num = number
+				if i + 1 < len(self._comm_groups) and self._comm_groups[i + 1][0] == 'ext':
+					ext = self._comm_groups[i + 1][1]
+					break
+
+		if ext:
+			return f'{num}x{ext}'
+		return num
+
+	@property
+	def fax_number(self):
+		qualifier = 'fax'
+		num = ''
+		ext = ''
+		for i, (q, number) in enumerate(self._comm_groups):
+			if q == qualifier:
+				num = number
+				# Check if the next qualifer is 'ext'
+				if i + 1 < len(self._comm_groups) and self._comm_groups[i + 1][0] == 'ext':
+					ext = self._comm_groups[i + 1][1]
+					break
+
+		if ext:
+			return f'{num}x{ext}'
+		return num
+
+	@property
+	def email(self):
+		for qualifier, email in self._comm_groups:
+			if qualifier == 'email':
+				return email
+
+	@property
+	def url(self):
+		for qualifier, url in self._comm_groups:
+			if qualifier == 'url':
+				return url
 
 	def __repr__(self):
 		return '\n'.join(str(item) for item in self.__dict__.items())

output/remits_poc/remit_payers/sample_835.txt

@@ -1,7 +1,7 @@
 remit_key|file_name|edi_transaction_id_st02|payer_id|payer_name|payer_address_line1|payer_address_line2|payer_city|payer_state|payer_zip|payer_country|payer_contact_business|payer_contact_business_qualifier|payer_contact_business_name|payer_contact_technical|payer_contact_technical_qualifier|payer_contact_technical_name|payer_contact_web|payer_contact_web_qualifier|payer_contact_web_name|payer_id_add|created_at
-22|sample_835.txt|1002||WSFG - BENEFITStest|400 BROADWAY||CINCINNATI|OH|45201||5136291100|TE|WESTERN SOUTHERN BENEFITS|5136291100|TE|WESTERN SOUTHERN BENEFITS||||31048|
-37|sample_835.txt|1002||WSFG - BENEFITStest|400 BROADWAY||CINCINNATI|OH|45201||5136291100|TE|WESTERN SOUTHERN BENEFITS|5136291100|TE|WESTERN SOUTHERN BENEFITS||||31048|
-78|sample_835.txt|1001||WSFG - BENEFITS|400 BROADWAY||CINCINNATI|OH|45201||5136291100|TE|WESTERN SOUTHERN BENEFITS|5136291100|TE|WESTERN SOUTHERN BENEFITS|FOR DISCOUNT QUESTIONS CALL ZELIS AT 1-888-266-3053. ALL OTHER CLAIM INQUIRIES CALL WESTERN SOUTHERN AT 513-629-1400. FOR DETAILED PAYMENT INFO, SEE THE EOP ON CHANGE HEALTHCARE WEBSITE.|UR||31048|
-102|sample_835.txt|1001||WSFG - BENEFITS|400 BROADWAY||CINCINNATI|OH|45201||5136291100|TE|WESTERN SOUTHERN BENEFITS|5136291100|TE|WESTERN SOUTHERN BENEFITS|FOR DISCOUNT QUESTIONS CALL ZELIS AT 1-888-266-3053. ALL OTHER CLAIM INQUIRIES CALL WESTERN SOUTHERN AT 513-629-1400. FOR DETAILED PAYMENT INFO, SEE THE EOP ON CHANGE HEALTHCARE WEBSITE.|UR||31048|
-129|sample_835.txt|1001||WSFG - BENEFITS|400 BROADWAY||CINCINNATI|OH|45201||5136291100|TE|WESTERN SOUTHERN BENEFITS|5136291100|TE|WESTERN SOUTHERN BENEFITS|FOR DISCOUNT QUESTIONS CALL ZELIS AT 1-888-266-3053. ALL OTHER CLAIM INQUIRIES CALL WESTERN SOUTHERN AT 513-629-1400. FOR DETAILED PAYMENT INFO, SEE THE EOP ON CHANGE HEALTHCARE WEBSITE.|UR||31048|
-146|sample_835.txt|1001||WSFG - BENEFITS|400 BROADWAY||CINCINNATI|OH|45201||5136291100|TE|WESTERN SOUTHERN BENEFITS|5136291100|TE|WESTERN SOUTHERN BENEFITS|FOR DISCOUNT QUESTIONS CALL ZELIS AT 1-888-266-3053. ALL OTHER CLAIM INQUIRIES CALL WESTERN SOUTHERN AT 513-629-1400. FOR DETAILED PAYMENT INFO, SEE THE EOP ON CHANGE HEALTHCARE WEBSITE.|UR||31048|
+22|sample_835.txt|1002||WSFG - BENEFITStest|400 BROADWAY||CINCINNATI|OH|45201||5136291100|phone|WESTERN SOUTHERN BENEFITS|5136291100|phone|WESTERN SOUTHERN BENEFITS||||31048|
+37|sample_835.txt|1002||WSFG - BENEFITStest|400 BROADWAY||CINCINNATI|OH|45201||5136291100|phone|WESTERN SOUTHERN BENEFITS|5136291100|phone|WESTERN SOUTHERN BENEFITS||||31048|
+78|sample_835.txt|1001||WSFG - BENEFITS|400 BROADWAY||CINCINNATI|OH|45201||5136291100|phone|WESTERN SOUTHERN BENEFITS|5136291100|phone|WESTERN SOUTHERN BENEFITS|FOR DISCOUNT QUESTIONS CALL ZELIS AT 1-888-266-3053. ALL OTHER CLAIM INQUIRIES CALL WESTERN SOUTHERN AT 513-629-1400. FOR DETAILED PAYMENT INFO, SEE THE EOP ON CHANGE HEALTHCARE WEBSITE.|url||31048|
+102|sample_835.txt|1001||WSFG - BENEFITS|400 BROADWAY||CINCINNATI|OH|45201||5136291100|phone|WESTERN SOUTHERN BENEFITS|5136291100|phone|WESTERN SOUTHERN BENEFITS|FOR DISCOUNT QUESTIONS CALL ZELIS AT 1-888-266-3053. ALL OTHER CLAIM INQUIRIES CALL WESTERN SOUTHERN AT 513-629-1400. FOR DETAILED PAYMENT INFO, SEE THE EOP ON CHANGE HEALTHCARE WEBSITE.|url||31048|
+129|sample_835.txt|1001||WSFG - BENEFITS|400 BROADWAY||CINCINNATI|OH|45201||5136291100|phone|WESTERN SOUTHERN BENEFITS|5136291100|phone|WESTERN SOUTHERN BENEFITS|FOR DISCOUNT QUESTIONS CALL ZELIS AT 1-888-266-3053. ALL OTHER CLAIM INQUIRIES CALL WESTERN SOUTHERN AT 513-629-1400. FOR DETAILED PAYMENT INFO, SEE THE EOP ON CHANGE HEALTHCARE WEBSITE.|url||31048|
+146|sample_835.txt|1001||WSFG - BENEFITS|400 BROADWAY||CINCINNATI|OH|45201||5136291100|phone|WESTERN SOUTHERN BENEFITS|5136291100|phone|WESTERN SOUTHERN BENEFITS|FOR DISCOUNT QUESTIONS CALL ZELIS AT 1-888-266-3053. ALL OTHER CLAIM INQUIRIES CALL WESTERN SOUTHERN AT 513-629-1400. FOR DETAILED PAYMENT INFO, SEE THE EOP ON CHANGE HEALTHCARE WEBSITE.|url||31048|

tests/conftest.py

@@ -39,3 +39,14 @@ def sample_935_with_interests():
 def nevada_medicaid_sample():
 	path = current_path + '/test_edi_835_files/nevada_medicaid.txt'
 	return edi_835_parser.parse(path)
+
+
+@pytest.fixture
+def exhaustive_sample_path():
+	return current_path + '/test_edi_835_files/exhaustive_sample.txt'
+
+
+@pytest.fixture
+def exhaustive_sample():
+	path = current_path + '/test_edi_835_files/exhaustive_sample.txt'
+	return edi_835_parser.parse(path)

tests/loops/test_claim.py

@@ -8,3 +8,18 @@ def test_medicaid_sample(nevada_medicaid_sample):
 
 	claim_loop = get_claim_by_control_number(nevada_medicaid_sample, '77777777')
 	assert claim_loop.claim.charge_amount == '72232'
+
+
+def test_can_parse_a_claim_contact(exhaustive_sample):
+	claim_loop = get_claim_by_control_number(exhaustive_sample, 'X')
+	assert claim_loop.contacts[0].name == 'XXXXX'
+	assert claim_loop.contacts[0].communication_no_or_url_qualifier == 'phone'
+	assert claim_loop.contacts[0].communication_no_or_url == 'XXXX'
+
+
+def test_reader_for_claim_payer_contacts(exhaustive_sample):
+	claim_loop = get_claim_by_control_number(exhaustive_sample, 'X')
+
+	assert claim_loop.claim_payer_contact.name == 'XXXXX'
+	assert claim_loop.claim_payer_contact.communication_no_or_url_qualifier == 'phone'
+	assert claim_loop.claim_payer_contact.communication_no_or_url == 'XXXX'

tests/segments/test_payer_contact.py

@@ -0,0 +1,56 @@
+from edi_835_parser.segments.payer_contact import PayerContact
+
+
+def test_payer_contact_initialization():
+	segment = '0:PER*CX*XX*FX*XXXXX*FX*XXXXXX*EX*XXX'
+	payer_contact = PayerContact(segment)
+
+	assert payer_contact.index == '0'
+	assert payer_contact.identifier == 'PER'
+	assert payer_contact.code == 'payers_claim_office'
+	assert payer_contact.name == 'XX'
+
+	assert payer_contact.communication_no_or_url_qualifier == 'fax'
+	assert payer_contact.communication_no_or_url == 'XXXXX'
+
+	assert payer_contact.communication_no_or_url_qualifier_2 == 'fax'
+	assert payer_contact.communication_no_or_url_2 == 'XXXXXX'
+
+	assert payer_contact.communication_no_or_url_qualifier_3 == 'ext'
+	assert payer_contact.communication_no_or_url_3 == 'XXX'
+
+
+def test_payer_contact_phone_number():
+	segment = '0:PER*CX*WESTERN SOUTHERN BENEFITS*TE*5136291100'
+	payer_contact = PayerContact(segment)
+
+	assert payer_contact.phone_number == '5136291100'
+
+
+def test_payer_contact_phone_number_with_ext():
+	segment = '0:PER*CX*WESTERN SOUTHERN BENEFITS*TE*5136291100*EX*123*FX*5136291109'
+	payer_contact = PayerContact(segment)
+
+	assert payer_contact.phone_number == '5136291100x123'
+
+
+def test_payer_contact_fax():
+	segment = '0:PER*CX*WESTERN SOUTHERN BENEFITS*TE*5136291100*FX*5136291109*EX*123'
+	payer_contact = PayerContact(segment)
+
+	assert payer_contact.fax_number == '5136291109x123'
+
+
+def test_payer_contact_email():
+	segment = '0:PER*BL*Nevada Medicaid*TE*8776383472*EM*[email protected]'
+	payer_contact = PayerContact(segment)
+
+	assert payer_contact.phone_number == '8776383472'
+	assert payer_contact.email == '[email protected]'
+
+
+def test_payer_contact_url():
+	segment = '0:PER*BL*PROVIDER SERVICES*TE*8003439000*UR*www.emedny.org'
+	payer_contact = PayerContact(segment)
+
+	assert payer_contact.url == 'www.emedny.org'

tests/test_edi_835_files/exhaustive_sample.txt

@@ -0,0 +1,52 @@
+ST*835*0001~
+BPR*U*00*C*NON*CTX*01*XXXXXXXX*DA*XXX*XXXXXXXXXX*XXXXXXXXX*01*XXX*DA*XXXX*20241019~
+TRN*1*XXXX*XXXXXXXXXX*XXX~
+CUR*PR*XXX~
+REF*EV*XXXXX~
+REF*F2*X~
+DTM*405*20241019~
+N1*PR*XXXXX*XV*XXX~
+N3*XXXX*XXXX~
+N4*XX*XX*XXX*XXX~
+REF*2U*XXX~
+PER*CX*XXXXXX*FX*XXX*TE*XXXXXX*EX*XXXXX~
+PER*BL*XXXX*TE*XXXXX*TE*XX*EM*XXX~
+PER*IC**UR*XXX~
+N1*PE*XXXXXX*XV*XXX~
+N3*XXXX*XXXX~
+N4*XX*XX*XXXXXX*XXX~
+REF*D3*XXX~
+RDM*EM*XXXX*XXXX~
+LX*000~
+TS3*XXXXX*X*20241019*00000000*00000000000000********000000**000000000000**0000000000000*00000000000**0000000*00*00000*0000*000000000000~
+TS2*0000000000*00000000000000*0000000000000*0000000000000*0000000000*0*00000000000000*0*000000*0000000000*0000000000*0000000000000*0000000000000*00*0000000000*00000000*00*0*00000000000~
+CLP*X*2*000000000*0000000000*00000000*MA*XXXXXX*X*X**XX*000000000000000*0000000~
+CAS*PR*XXX*00000000*000000000*XX*00000000*000000000000*XXX*00000000000*0000*XX*000000000*000000000000*XX*000000000000*0000000000000*XX*0000000*00000~
+NM1*74*2*XX*X*XXXXX**XXXX*C*XXXXXXX~
+NM1*PR*2*XXXX*****NI*XX~
+NM1*TT*2*XX*****PI*XXXXXX~
+NM1*IL*X*XXXXX*XXXXXX****XX*XXXXXXX~
+NM1*GB*2*XXXXX*XX*XXX**XXXXXX*MI*XXX~
+NM1*QC*1*X*XXX*XXXX**XX*MI*XXXX*XX~
+NM1*82*1*XXXXX*XXXX*X**XXXX*MC*XX~
+MIA*0000*00*0*00*XXXX*0000*0000000*000*000000*00*0000*00*0000000000000*00000000000000*000000000000000*0000000*0*000000000*000000*XXXXX*XXXXXX*XXX*X*0~
+MOA*000*0000000000000*XXXXX*XXX*XXX*XXXXXX*XX*000000000*00~
+REF*EA*X~
+DTM*050*20241019~
+DTM*036*20241019~
+DTM*233*20241019~
+PER*CX*XXXXX*TE*XXXX*FX*XXX*EX*XXXXXX~
+AMT*ZN*0000~
+QTY*CA*000000~
+SVC*NU>XXXX>XX>XX>XX>XX*000000000000000*0*X*0000*HC>XXXX>XX>XX>XX>XX>XXXXX*00000000~
+DTM*151*20241019~
+CAS*OA*X*000000000000000*000000000000000*XXXXX*00*000000000*XXXXX*000000000000*0000*XXX*0000000*0*XXX*00000*0000000000*XXX*0000*00000000000~
+REF*0K*XXXXX~
+REF*6R*XXXXX~
+REF*SY*XXX~
+REF*APC*XXXXXX~
+AMT*KH*0000000~
+QTY*ZM*0~
+LQ*HE*XXXX~
+PLB*XXXX*20241019*GO>XXXX*0000000*XX>XXXXXX*00000*XX>XXX*00000000000000*XX>X*0000000000000*XX>XXXXXX*000000*XX>XX*0000000~
+SE*52*0001~

tests/test_edi_835_parser.py

@@ -1,4 +1,5 @@
 from decimal import Decimal
+import logging
 import os
 import subprocess
 
@@ -48,6 +49,21 @@ def test_total_interests(sample_935_with_interests):
 	assert sum_interests(sample_935_with_interests) == round(Decimal(10.3), 2)
 
 
+def test_can_parse_edi_files_without_warnings(exhaustive_sample_path, caplog):
+	import edi_835_parser
+
+	with caplog.at_level(logging.INFO, logger='edi_835_parser'):
+		edi_835_parser.parse(exhaustive_sample_path)
+		assert 'Identifier: PER not handled in claim loop.' not in caplog.text
+
+		# These are not yet supported
+		# assert 'Identifier: CUR not handled in transaction loop.'
+		# assert 'Identifier: RDM not handled in organization loop.'
+		# assert 'Identifier: TS2 not handled in transaction loop. '
+		# assert 'Identifier: QTY not handled in claim loop.'
+		# assert 'Identifier: QTY not handled in service loop.'
+
+
 def test_cli_output_snapshot():
 	OUTPUT_DIR = 'output/remits_poc'
 	# List all the files in the output directory recursively