Merge pull request sbuss#12 from CloudCray/explicit_network_benefits

Explicit "network" values for `EligibilityOrBenefitInformation`

README.md

@@ -1,6 +1,14 @@
 TigerShark is an X12 EDI message parser that can be tailored to
 a specific partner in the health care payment ecosystem.
 
+Version 0.3.3
+-------------
+
+* Adds `in_plan_network_type` to `EligibilityOrBenefitInformation` for explicit values
+* Adds `out_of_plan_network` for completion's sake
+* Note that `in_plan_network`, `out_of_plan_network`, and `both_in_out_network` all return `False` when no value is set, although `None` would probably be more appropriate
+* It may be more intuitive if `in_plan_network` and `out_of_plan_network` returned `True` when `both_in_out_network` is `True`, but the behavior is preserved for backwards compatibility
+
 Version 0.3.2
 -------------
 

tests/271-example-in-out-network.txt

@@ -0,0 +1,50 @@
+ISA|00|          |00|          |ZZ|ZIRMED         |ZZ|10864          |160405|1354|}|00501|000184077|1|P|^~
+GS|HB|ZIRMED|10864|20160301|1354|184065|X|005010X279A1~
+ST|271|0001|005010X279A1~
+BHT|0022|11|94309|20160301|134403~
+HL|1||20|1~
+NM1|PR|2|MEDICA COM|||||PI|123456789~
+HL|2|1|21|1~
+NM1|1P|1|James|Barraret|J.|||XX|1234567894~
+HL|3|2|22|0~
+TRN|2|434343434|9ZIRMEDCOM|ELR ID~
+TRN|1|422422424|9ZIRMEDCOM|ELI ID~
+NM1|IL|1|SMITH|JOHN||||MI|1234567899~
+REF|18|0404044~
+REF|6P|030030001000120|NEVADA EXCHANGE~
+N3|4040 VILLAGE AB~
+N4|KANSAS CITY|MO|64108~
+DMG|D8|19430813|M~
+INS|Y|18|001|25~
+DTP|346|D8|20160201~
+DTP|472|D8|20160601~
+DTP|356|D8|20141208~
+EB|L|EMP|30|EP~
+MSG|PCP SELECTION NOT REQUIRED~
+EB|W~
+LS|2120~
+NM1|PR|2|Mala Compania~
+N3|PO Box 983322~
+N4|El Fixato|TX|68887~
+LE|2120~
+EB|1|EMP|30|EP|Open Access Elect Choice~
+EB|G|IND|30|C1|||1500|||||Y~
+EB|G|IND|30|C1||24|1500|||||Y~
+EB|G|IND|30|C1||29|0|||||Y~
+EB|C|IND|30||||118|||||Y~
+EB|C|IND|30|||24|118|||||Y~
+EB|C|IND|30|||29|0|||||Y~
+EB|G|IND|30|C1|||0|||||N~
+EB|G|IND|30|C1||24|0|||||N~
+EB|G|IND|30|C1||29|0|||||N~
+EB|C|IND|30||||0|||||N~
+EB|C|IND|30|||24|0|||||N~
+EB|C|IND|30|||29|0|||||N~
+EB|B|EMP|98||||50|||||Y~
+EB|B|EMP|98||||100|||||N~
+EB|A|IND|50|||27||0.1||||W~
+EB|A|IND|52|||||0.1
+EB|I|EMP|1}33}48}50}86}98}UC|||||||||N~
+SE|74|0001~
+GE|1|184065~
+IEA|1|000184077~

tests/test_271_network_indicator.py

@@ -0,0 +1,65 @@
+import unittest
+import logging
+import sys
+
+from tigershark.facade import f271
+from tigershark.parsers import M271_5010_X279_A1
+
+
+class TestParsed271(unittest.TestCase):
+    def setUp(self):
+        m = M271_5010_X279_A1.parsed_271
+        with open('tests/271-example-in-out-network.txt') as f:
+            parsed = m.unmarshall(f.read().strip())
+        self.f = f271.F271_5010(parsed)
+
+    def test_number_of_facades(self):
+        self.assertEqual(len(self.f.facades), 1)
+
+    def test_no_network_info(self):
+        subscriber = self.f.facades[0].subscribers[0]
+        benefit = subscriber.eligibility_or_benefit_information[2]
+        cov_info = benefit.coverage_information
+
+        self.assertEqual(cov_info.in_plan_network_type, None)
+        self.assertEqual(cov_info.in_plan_network, False)
+        self.assertEqual(cov_info.both_in_out_network, False)
+        self.assertEqual(cov_info.out_of_plan_network, False)
+
+    def test_both_network_info(self):
+        subscriber = self.f.facades[0].subscribers[0]
+        benefit = subscriber.eligibility_or_benefit_information[17]
+        cov_info = benefit.coverage_information
+
+        self.assertEqual(cov_info.in_plan_network_type[0], "W")
+        self.assertEqual(cov_info.in_plan_network, False)
+        self.assertEqual(cov_info.both_in_out_network, True)
+        self.assertEqual(cov_info.out_of_plan_network, False)
+
+    def test_out_of_network_info(self):
+        subscriber = self.f.facades[0].subscribers[0]
+        benefit = subscriber.eligibility_or_benefit_information[16]
+        cov_info = benefit.coverage_information
+
+        self.assertEqual(cov_info.in_plan_network_type[0], "N")
+        self.assertEqual(cov_info.in_plan_network, False)
+        self.assertEqual(cov_info.both_in_out_network, False)
+        self.assertEqual(cov_info.out_of_plan_network, True)
+
+    def test_in_network_info(self):
+        subscriber = self.f.facades[0].subscribers[0]
+        benefit = subscriber.eligibility_or_benefit_information[15]
+        cov_info = benefit.coverage_information
+
+        self.assertEqual(cov_info.in_plan_network_type[0], "Y")
+        self.assertEqual(cov_info.in_plan_network, True)
+        self.assertEqual(cov_info.both_in_out_network, False)
+        self.assertEqual(cov_info.out_of_plan_network, False)
+
+
+if __name__ == "__main__":
+    logging.basicConfig(
+        stream=sys.stderr,
+        level=logging.INFO,
+    )
+    unittest.main()

tigershark/X12/parse.py

@@ -681,7 +681,7 @@ def parse( self, segments ):
         """If this segment matches the next segment token in the input,
         create the X12Segment object.
         :param segments: list of SegmentTokens for the current message.
-        :returns: yields a single parsed Segment or raises StopIteration
+        :returns: yields a single parsed Segment or ends iteration (returns)
         """
         if isinstance(self.repeat, int):
             length_loop = range(self.repeat)
@@ -745,7 +745,7 @@ def parse( self, segments ):
         loops until a segment no longer matches.
 
         :param segments: list of SegmentToken instances
-        :returns: Yields the next X12.message.X12Loop structure or raises StopIteration
+        :returns: Yields the next X12.message.X12Loop structure or ends interation (returns)
         """
         # Confirm match between this loop and a segment of the structure
         i = 0

tigershark/__init__.py

@@ -2,7 +2,7 @@
 TigerShark - An X12 EDI message parser.
 """
 __all__ = ['X12VersionTuple']
-__version__ = "0.3.2"
+__version__ = "0.3.3"
 __authors__ = [
     "Steven Buss <[email protected]>",
     "Steven Lott <[email protected]>",

tigershark/facade/__init__.py

@@ -617,7 +617,7 @@ def compositeList(self, *names):
         sep = self.segment.message.getCompositeSeparator()
         result = []
         pos = 1
-        while self.segment.getByPos(pos) is not "":
+        while self.segment.getByPos(pos) != "":
             composite = self.segment.getByPos(pos)
             subElts = composite.split(sep)
             if subElts[0] in names:

tigershark/facade/f271.py

@@ -123,7 +123,13 @@ class EligibilityOrBenefitInformation(X12SegmentBridge):
     authorization_or_certification = ElementAccess("EB", 11,
             x12type=boolean("Y"))
     in_plan_network = ElementAccess("EB", 12, x12type=boolean("Y"))
+    out_of_plan_network = ElementAccess("EB", 12, x12type=boolean("N"))
     both_in_out_network = ElementAccess("EB", 12, x12type=boolean("W"))
+    in_plan_network_type = ElementAccess("EB", 12, x12type=enum({
+        "Y": "In Plan Network",
+        "N": "Out of Plan Network",
+        "W": "Both In and Out of Plan Network",
+    }))
     ada_code = CompositeAccess("EB", "AD", 13)
     cpt_code = CompositeAccess("EB", "CJ", 13)
     hcpcs_code = CompositeAccess("EB", "HC", 13)