# File lib/trizetto/api/eligibility/web_service/benefit.rb, line 109 def primary_care_provider? info == "Primary Care Provider" end
class Trizetto::Api::Eligibility::WebService::Benefit
A Benefit
provided by the insurance.
Example XML
<benefit> <info>Out of Pocket (Stop Loss)</info> <coveragelevel>Family</coveragelevel> <servicetype>Health Benefit Plan Coverage</servicetype> <servicetypecode>30</servicetypecode> <time_period_qualifier>Remaining</time_period_qualifier> <benefitamount>13097.6</benefitamount> <plannetworkindicator>In Plan-Network</plannetworkindicator> <message>BUT NO MORE THAN INDIVIDUAL AMOUNT PER MEMBER (ACCUMULATES WITH OUT-OF-NETWORK AMOUNTS)</message> <message>CALCULATION INCLUDES DEDUCTIBLE, COPAYMENTS AND COINSURANCE FOR MEDICAL AND PRESCRIPTION DRUG BENEFITS.</message> </benefit>
Example
benefit.info # => "Out of Pocket (Stop Loss)" benefit.messages # => ["BUT NO MORE THAN...", "CALCULATION INCLUDES ...."]
Example XML
<benefit> <info>Active Coverage</info> <coveragelevel>Family</coveragelevel> <servicetype>Health Benefit Plan Coverage</servicetype> <servicetypecode>30</servicetypecode> <insurancetype>Preferred Provider Organization (PPO)</insurancetype> <insurancetypecode>PR</insurancetypecode> <plancoveragedescription>PPO - PREFERRED BLUE PPO SAVER</plancoveragedescription> </benefit>
Example
benefit.info # => "Active Coverage<" benefit.service_type_codes # => ["30"]
Constants
- KEY_CLEANUP
- REQUIRED_KEYS
Public Class Methods
new(raw_hash = {})
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Calls superclass method
# File lib/trizetto/api/eligibility/web_service/benefit.rb, line 67 def initialize(raw_hash = {}) clean_hash = raw_hash.dup # Convert message, which is either a single or multiple entry int # the SOAP, which then gets turned into a string or an array by # Nori into a messages aaray clean_hash[:messages] = Array(clean_hash.delete(:message)) if clean_hash.has_key?(:message) # Service type codes indicate the type of benefit. # The magic decoder for ID => human meaning is here: http://www.x12.org/codes/health-care-service-type-codes/ # Multiple service type codes with the same benfit are combined with a ^ # so we turn a single servicetypecode entry into an array of service types clean_hash[:service_type_codes] = (clean_hash.delete(:servicetypecode) || '').split("^") super(clean_hash) if self.entity.is_a?(Hash) self.entity = BenefitEntity.new(self.entity) end end
Public Instance Methods
active_coverage?()
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Is this active insurance coverage?
# File lib/trizetto/api/eligibility/web_service/benefit.rb, line 89 def active_coverage? info == "Active Coverage" end
co_insurance?()
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# File lib/trizetto/api/eligibility/web_service/benefit.rb, line 97 def co_insurance? info == "Co-Insurance" end
inactive?()
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# File lib/trizetto/api/eligibility/web_service/benefit.rb, line 93 def inactive? info == "Inactive" end
limitation?()
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# File lib/trizetto/api/eligibility/web_service/benefit.rb, line 101 def limitation? info == "Limitations" end
non_covered?()
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# File lib/trizetto/api/eligibility/web_service/benefit.rb, line 105 def non_covered? info == "Non-Covered" end
primary_care_provider?()
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