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Merge pull request #12 from CloudCray/explicit_network_benefits
Explicit "network" values for `EligibilityOrBenefitInformation`
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‎README.md‎

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TigerShark is an X12 EDI message parser that can be tailored to
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a specific partner in the health care payment ecosystem.
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Version 0.3.3
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-------------
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* Adds `in_plan_network_type` to `EligibilityOrBenefitInformation` for explicit values
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* Adds `out_of_plan_network` for completion's sake
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* 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
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* 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
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Version 0.3.2
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-------------
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‎tests/271-example-in-out-network.txt‎

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

‎tests/test_271_network_indicator.py‎

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

‎tigershark/X12/parse.py‎

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

‎tigershark/__init__.py‎

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

‎tigershark/facade/__init__.py‎

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sep = self.segment.message.getCompositeSeparator()
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result = []
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pos = 1
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while self.segment.getByPos(pos) is not "":
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while self.segment.getByPos(pos) != "":
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composite = self.segment.getByPos(pos)
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subElts = composite.split(sep)
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if subElts[0] in names:

‎tigershark/facade/f271.py‎

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

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